Earlier in the year, our own Dr Frank Lin travelled to Stuttgart, Germany, to attend the 25th Stuttgart Advanced Course for Functional and Aesthetic Rhinoplasty, a Rhinoplasty Cadaver Course and the 2nd Stuttgart Symposium on Nose Reconstruction.
The course speaker, Prof. Dr. med. Dr. h.c. Wolfgang Gubisch, invited selected surgeons of international reputation with whom to discuss his surgical philosophy. Focusing on live cases and open demonstrations, the course was an exploration of one of the most popular surgical procedures that demands the highest level of surgical expertise. The nose is a distinctive feature that has a significant effect on the overall aesthetic impression of the face.
Nose reconstruction is recognised as the most challenging field of Facial Reconstructive Plastic Surgery, and the development of techniques is constantly progressing. One of the primary objectives of the course was to update international surgeons on new procedural techniques in rhinoplasty. The course included lectures, interactive video presentations, panel discussions and live surgical demonstrations.
The main focus of the event was surgical demonstration, with guests given the opportunity to increase their knowledge of rhinoplasty during live surgical courses. Challenging rhinoplasty cases were demonstrated, including several featuring patients seeking revision surgery after failed procedures. Emphasis was put on the importance of undertaking a detailed analysis before each operation, ensuring that an appropriate technique is selected for each case to achieve the best result.
The Anatomy of the Nose
The outside of the nose is divided into three sections, while the inside of the nose contains the nasal septum. The upper section of the nose is formed by the nasal and cheek bones, and the middle third is made of cartilage – stiff down the bridge of the nose and softer at the sides. The lower third is comprised of the right and left lower cartilages, which are shaped like wings and arch over the nostrils.
The nasal septum is contained inside the nose. It is a wall that separates the two sides of the nose and is made of thin cartilage and bone, covered by a mucous membrane.
Different Types of Rhinoplasty
Cosmetic rhinoplasty refers to surgery that focuses on the aesthetic appearance of the nose, while the main goal of functional rhinoplasty is to restore the ability to breathe through the nose. However, a good nasal surgery should optimise both appearance and nasal breathing.
In a “closed” rhinoplasty, all surgical incisions are hidden within the nostril, avoiding a potentially visible scar. This process also limits the surgical exposure, however, which means that it would be difficult to utilise many of the complex surgical techniques popular today.
“Open” rhinoplasty allows for direct visualisation of the nasal skeleton, allowing the surgeon to modify the skeletal framework without interference from the overlying tissue. While the incision resulting from this type of surgery is initially visible, the scar often completely fades in the months following surgery. For many people considering undergoing nasal surgery, there are more advantages to be gained by the open approach that outweigh the risk of a columellar scar.
Dr Lin specialises in Asian rhinoplasty, cosmetic nose surgery which specifically addresses features common amongst people of Asian heritage. During these surgeries, more height may be added to the nose, or the nose may be narrowed and a sharper tip created.